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KMID : 0358420090520040413
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Korean Journal of Obstetrics and Gynecology
2009 Volume.52 No. 4 p.413 ~ p.419
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Pregnancy outcomes of antenatally diagnosed congenital cystic adenomatoid malformation of Lung
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Oh Kyung-Joon
Yang Hye-Jin
Lee Kyung-A
Lee Seung-Mi
Lee Joon-Ho
Park Chan-Wook
Park Joong-Shin
Jun Jong-Kwan
Syn Hee-Chul
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Abstract
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Objective: To determine the accuracy of antenatal diagnosis, pregnancy outcome and the predictors for adverse outcome in antenatally diagnosed congenital cystic adenomatoid malformation (CCAM).
Methods: A retrospective review was performed on a total of 32 patients with antenatally diagnosed CCAM between January, 1999 and June, 2008.
Results: Of 32 cases with antenatally diagnosed CCAM, 8 patients were lost to follow-up. In remaining 24 patients, postnatal histologic examination and/or radiologic study showed definitive diagnostic features of CCAM (n=20), pulmonary sequestration (n=3) and congenital lobar emphysema (n=1). The accuracy of antenatal diagnosis was 83.3% (20/24). The rate of presence of hydrops and/or ascites was 10% (2/20) in those with CCAM confirmed postnatally. Of the 2 patients with ascites and/or hydrops, thoraco-amniotic (TA) shunt was performed in one case with hydrops and termination was done in the other case. All of the 15 cases with ongoing pregnancy were delivered at term, except one with TA-shunt who was born at 33+3 weeks of gestation (mean gestational age at birth±standard deviation; 39.6 2.2 weeks, mean birth weight; 3,200±500 gram). All 15 neonates were discharged alive without any complication. Antenatal sonographic microcystic lesion was associated with postnatal histologic type III lesion [5 type III lesions in 7 microcystitc cases (71.4%) vs. no type III lesion in 13 macrocystic cases (0%), P<0.01].
Conclusion: The incidence of ascites and/or hydrops was 10% (2/20) in fetuses with CCAM. Antenatally diagnosed CCAM has an excellent prognosis in the absence of signs of ascites and/or hydrops.
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KEYWORD
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Congenital cystic adenomatoid malformation of Lung, Antenatal diagnosis, Pregnancy outcome
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